In this application we propose to evaluate an unusually high uterine cervical cancer incidence in the Republic of Panama. Panama not only has one of the highest reported cervical cancer rates in the world but also demonstrates marked geographic clustering and a shift in age specific incidence to women in the 20-39 year age group. We plan to evaluate this by first recording all cervical cancer cases which occurred between 1974-1978 in a standardized national cancer register. We will then do a seroepidemiologic case control study comparing socioeconomic, sexual and herpes group virus risk factors which operate in cases and controls. In addition we plan to measure other variables which might account for the unique aspects of cervical cancer seen in Panama. Lastly we will evaluate the effects of the existing Pap smear program and collaborate in initiation of a more intensive screening program.